Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. A new study from Denmark suggests that a serious infection or autoimmune disease could trigger a mood disorder. How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.
The bombs that exploded on Monday near the finish line of the Boston Marathon killed three people, physically injured nearly 200 others, and traumatized thousands more. Recovery and healing are beginning for the families of those who died, for the injured and their families, and for others touched by this tragedy. For some, healing will be swift. For others it will be measured in small steps over months, and possibly years. The Marathon explosions will leave a legacy of emotional scars along with the physical ones, even among those who weren’t anywhere near the blasts. Some people who were at the scene of the explosions will undoubtedly develop post-traumatic stress disorder (PTSD). But PTSD is not the only response to frightening events. In fact, most people exposed to a trauma do not develop this condition. They may develop an anxiety disorder, for example, or become depressed. Most people do have some emotional response, but the majority develop no illness at all.
Physical and mental activities are both important for protecting your thinking skills and warding off dementia. But does one trump the other? A study published yesterday in JAMA Internal Medicine tried to tease out if one was better than the other for brain health. Researchers recruited 126 older adults who felt that their memory or thinking skills had recently gotten worse, and divided them into four groups. All were asked to do an hour of mental activity three times a week and an hour of physical activity three times a week. What differed were the intensities of these activities. After 12 weeks, scores on thinking tests improved across the board. The big surprise was that there weren’t any real differences in improvement between the groups. The researchers concluded that the amount of activity is more important for stimulating the brain than the type of activity, because all of the participants both exercised and engaged in mental activities each week.
New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer. The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997. The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated. “When in doubt, sit it out.” The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously. The new guidelines should help better identify athletes who have suffered concussions and improve how concussions are managed and treated.
Americans are a diverse lot, so it’s no surprise they give different answers when asked about their well-being. But it seems that well-being differs from state to state, too. In the latest Gallup-Healthways Well-Being Index, which gauges the physical and emotional health of people in all 50 states, residents of Hawaii reported the best sense of overall well-being while West Virginia residents reported the worst. The index calculates overall well-being based on six quality of life categories, each of which is made up of several components. Poll respondents in Hawaii had the highest scores in the emotional health and work environment indexes, and were most likely to say they were thriving. People in West Virginia were most likely to say they were not thriving, and had the worst emotional health, the worst health habits, the most diagnoses of depression, and high rates of obesity. People in the other 50 states fell in between. It’s possible to change both emotional and physical well-being, and improve happiness.
Five seemingly different mental health disorders—major depression, bipolar disorder, schizophrenia, autism, and attention-deficit hyperactivity disorder—may be more alike than we think. A ground-breaking new study has identified four regions of the genetic code that carry same variations in people with these disorders. Two of the affected genes help control the movement of calcium in and out of brain cells. That might not sound like much, but this movement provides a key way that brain cells communicate. Subtle differences in calcium flow could cause problems that, depending on other genes or environmental factors, could eventually lead to a full-blown mental illness. But this work offers tantalizing hints that bipolar disorder, major depression, and schizophrenia—and possibly autism and attention-deficit hyperactivity disorder—may not be so distinct after all, but could be different manifestations of the same underlying disorder. This could change the way we view mental illness and open the door to more effective therapies.
With Black Friday upon us, the holiday season is now officially underway. Although the next month or so provides many opportunities to see family and friends, be generous, and spread good cheer, it can also be a difficult time. In a stressed-out heartbeat, the holiday season can morph into the hell-iday season. Deep breathing, meditation, progressive muscle relaxation, and visualization can evoke a state of rest and release. Doing them can slow your heartbeat, calm your breathing, lower your blood pressure, and help you chill out. You can’t necessarily eliminate the seasonal stressors. But you can counter them using mini-relaxation exercises, whether you have 10 minutes to spare or just one minute.
The Thanksgiving holiday began, as its name implies, when the colonists gave thanks for surviving their first year in the New World and for a good harvest. Nearly 400 years later, we’re learning that the simple act of giving thanks is not just good for the community but may also be good for the brain and body. Gratitude helps people refocus on what they have instead of what they lack. By acknowledging the goodness in their lives, expressing gratitude often helps people recognize that the source of that goodness lies at least partially outside themselves. This can connect them to something larger—other people, nature, or a higher power. In the relatively new field of positive psychology research, gratitude is strongly and consistently linked to greater happiness. Although some people may be born with a gift for expressing gratitude, anyone can learn how to do it. And this mental state grows stronger with use and practice. Here are some ways to cultivate gratitude.
One treatment that can help relieve depression and other mental or emotional problems is cognitive behavioral therapy. It guides individuals to change what they think. A related approach, called metacognitive therapy, helps individuals change how they think. Some preliminary but promising research suggests that metacognitive therapy may be useful for people with attention deficit hyperactivity disorder (ADHD). One study of 88 adults with ADHD found that metacognitive therapy led to significant reduction in ADHD symptoms in 42% of participants, compared to 12% who received supportive therapy. Keep in mind that metacognitive therapy is not yet a proven therapy. More research is needed on its effectiveness in different settings. But that means it doesn’t yet stack up to its elder cousin, cognitive behavioral therapy. And metacognitive therapy can’t be considered as a first line treatment for ADHD.
A close friend of one of my colleagues committed suicide last week. It happened as so many suicides do—out of the blue. A few days earlier, my colleague had spent the day hanging out with her friend, who was relaxed, upbeat, and normal. Sadly, that’s not uncommon. Many people who commit suicide don’t have an identifiable mental health problem, or give any hints that they are thinking about taking their lives. Every suicide, like every person, is different. Many are sparked by intense feelings of anger, despair, hopelessness, or panic. Suicide almost always raises anguished questions among family members and friends left behind: What did I miss? What could I have done? In my friend’s case, the answers are nothing and nothing. When individuals suddenly take their own lives with no warning, all we can do is look to each other for support. It may be natural to ask, “What did I miss?” But we should remind ourselves what experts say: This kind of death defies prediction.